Söderberg Stefan, Stegmayr Birgitta, Ahlbeck-Glader Christine, Slunga-Birgander Lisbeth, Ahrén Bo, Olsson Tommy
Department of Medicine, Clinical Chemistry of Umeå University, Umeå, Sweden.
Cerebrovasc Dis. 2003;15(1-2):63-9. doi: 10.1159/000067128.
Leptin, an important hormone for body weight regulation, may be involved in the pathogenesis of cardiovascular manifestations of obesity. We tested whether leptin may be an independent risk marker for stroke in a case-referent study.
Definitive acute stroke events, defined by MONICA criteria, were identified from October 1, 1995 to April 30, 1999. Referents without known cardiovascular disease were randomly selected from a population census. Patient characteristics were taken from hospital files and leptin was analyzed in stored samples. Logistic regression analysis was used to determine possible differences in leptin levels between groups.
One hundred and thirty-seven cases with ischemic stroke and 69 cases with hemorrhagic stroke were identified. In comparison with referents, male patients with stroke had significantly higher leptin levels. Both male and female stroke patients had increased blood pressure compared with the referents. In multivariate analyses, high leptin levels were associated with both ischemic (OR = 4.89; 95% CI: 1.89-12.62) and hemorrhagic (OR = 3.86; 95% CI: 1.13-13.16) stroke in men, and with ischemic stroke in women (OR = 4.10; 95% CI: 1.45-11.62). The combination of high leptin levels and increased blood pressure (systolic or diastolic) was associated with a strong positive interaction in males with hemorrhagic stroke.
Leptin may be an important link for the development of cerebrovascular disease in the insulin resistance syndrome in men.
瘦素是一种调节体重的重要激素，可能参与肥胖相关心血管表现的发病机制。我们在一项病例对照研究中检验了瘦素是否可能是卒中的独立风险标志物。
依据莫尼卡（MONICA）标准确定1995年10月1日至1999年4月30日期间的明确急性卒中事件。从人口普查中随机选取无已知心血管疾病的对照者。患者特征取自医院病历，并对储存样本中的瘦素进行分析。采用逻辑回归分析确定各组间瘦素水平的可能差异。
共识别出137例缺血性卒中和69例出血性卒中患者。与对照者相比，男性卒中患者的瘦素水平显著更高。与对照者相比，男性和女性卒中患者的血压均升高。在多变量分析中，高瘦素水平与男性的缺血性卒中（比值比[OR]=4.89；95%置信区间[CI]：1.89 - 12.62）和出血性卒中（OR = 3.86；95% CI：1.13 - 13.16）相关，与女性的缺血性卒中（OR = 4.10；95% CI：1.45 - 11.62）相关。高瘦素水平与血压升高（收缩压或舒张压）的联合在男性出血性卒中患者中存在强烈的正相互作用。
瘦素可能是男性胰岛素抵抗综合征中脑血管疾病发生发展的重要环节。
